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Monitoring System Certification <br />[1111 1 1 1 r <br />Site Address: <br />::::::.... 0'p�:::::::::::::::::::::::::::::::::::::: <br />. . . . . . . . . . . C? to, A0vv�: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . <br />...........0. �. Y <br />................. <br />............:��Q ......:................. <br />. 7..b—. ...... ........ . . <br />s . Yti . . . . . . . . 6 ;GK aR : . . . . . . . . . . . <br />... ................. <br />....................... <br />..... ....................I................. .............................. <br />................. <br />1.: ......................... <br />........... I........................ <br />.: : : :P b4 VA ............... ...................... <br />. . . . . . . . . . . . . ��,k.ttv.ri. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . <br />0�i1\.............. ......... ............ <br />................... ............ I..................... <br />...................................... I.............. <br />...................................................... <br />..................................................... <br />...................................... I .......... I — <br />.............. ............ I.......................... <br />.......... ............................. ..... I........ <br />..................................................... <br />..................................................... <br />Date map was drawn: <br />Instructions <br />If you already have a diagram that shows all required information, you may include it, rather than this page, with your <br />Monitoring System Certification. On your site plan, show the general layout of tanks and piping. Clearly identify <br />locations of the following equipment, if installed: monitoring system control panels; sensors monitoring tank annular <br />spaces, sumps, dispenser pans, spill containers, or other secondary containment areas; mechanical or electronic line leak <br />detectors; and in -tank liquid level probes (if used for leak detection). In the space provided, note the date this Site Plan <br />was prepared. <br />Page of 05/00 <br />